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. 2023 Oct 18;11(4):143.
doi: 10.3390/diseases11040143.

Cold Anaphylaxis in Children: Italian Case Series and Review of the Literature

Leonardo Tomei  1   2 , Francesca Saretta  3 , Stefania Arasi  4 , Lucrezia Sarti  1 , Amelia Licari  5 , Mattia Giovannini  1   2 , Simona Barni  1 , Giulia Liccioli  1 , Valeria Tallarico  6 , Alessandra Piccorossi  7 , Carlo Caffarelli  8 , Elio Novembre  2 , Francesca Mori  1
Affiliations

Cold Anaphylaxis in Children: Italian Case Series and Review of the Literature

Leonardo Tomei et al. Diseases. .

Abstract

Chronic urticaria (CU) is one of the most common skin disorders worldwide. Among the inducible subgroup of CU, cold urticaria (ColdU) can affect both children and adults and is the only type associated with the risk of anaphylaxis without cofactors. In the scientific literature, data about cold anaphylaxis (ColdA) are poor, especially at pediatric age, and little is known about risk factors associated with the onset of systemic reactions and about the criteria for prescribing adrenaline auto-injectors (AAIs) in these patients. We describe the clinical characteristics and management of a case series of 21 patients with a history of ColdA, and we compare them with the pediatric case reports and case series published so far. On the basis of the scientific literature and of our case series of patients, we suggest that AAI should be prescribed to all high-risk patients: those with urticaria caused by cold-water immersion, oropharyngeal reactions, and with a previous history of systemic symptoms or anaphylaxis.

Keywords: anaphylaxis; chronic urticaria; cold urticaria; pediatrics.

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Conflict of interest statement

The authors declare that they have no conflict of interest to disclose in relation to this paper.

Figures

Figure 1
Figure 1
ColdU in a 5-year-old boy.
Figure 2
Figure 2
Management for ColdU/ColdA patients from counseling to experimental drugs.
See this image and copyright information in PMC

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